Authors:

3 Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.

The ideal perioral and lip rejuvenation technique provides the longest period of efficacy, lowest complication rate, and best esthetic results. Genetics, intrinsic aging, sun exposure, and repetitive muscle twitching of the orbicularis oris produce angular, radial, and vertical lines of the perioral lines and, for this reason, the needs of patients in the treatment of this anatomical area can range from simple lip enhancement to a broader and more comprehensive treatment with simultaneous correction of perioral wrinkles. A myriad of materials have been described for rejuvenation of this area. Read More

Department of Oral Pathology and Medicine, School of Dentistry, National and Kapodistrian University of Athens, Greece.

Squamous cell carcinoma (SCC) developing in lesions of discoid lupus erythematosus (DLE) is rare, most frequently arising on sun-exposed skin and very rarely affecting the lips. A review of the English language literature revealed only 21 published cases of labial SCC in patients with DLE. Here, an unusual case of a patient with DLE who developed 3 primary SCCs of the oral and perioral region is presented. Read More

Authors:

The perioral region is unique and important in the face, both from a functional and an aesthetic point of view. There is a strong relationship between the perioral soft tissues, such as the lips and the corners of the mouth, and the underlying dentition and the jaws. Perioral ageing phenomena, such as depressed corners of the mouth, volume loss and wrinkles, can be improved, however, to a limited extent with intraoral treatment. Read More

Furuncular myiasis is a parasitic infection caused by the larvae of Dipteran insects after penetrating healthy skin, causing an erythematous nodule with a central pore. Additionally, the patient may feel a sensation of movement and intermittent pain. Furuncular myiasis affecting the oral and perioral region is rare, usually leading to misdiagnosis. Read More

Lip and chin scarring occurs owing to reconstruction of congenital, cancer resection, or traumatic defects. Knowledge of lip anatomy and function is critical to optimize results. Realistic expectations should be established before intervention. Read More

Authors:

From the Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Freiburg, Germany.

Background: Although aging changes of the female perioral region and aesthetic procedures for perioral rejuvenation are described in literature, specific data for the male population are lacking. This study aims to evaluate perioral aging process in the male population to compare quality and quantity of the observed changes to the female population.

Methods: Magnetic resonance imaging (MRI) scans of 22 male subjects, were recruited into 2 age groups: young (20-35 years) and old (65-80 years) and the following parameters were measured: length of visible upper lip, thickness of upper lip at the level of vermilion border, thickness of upper lip at the level of the mid lip, and cross-section area of upper lip. Read More

The ultrasonographic surface rendered oro-palatal (SROP) view is a 3D reconstructed view of the fetal perioral region, which combines ultrasound insonation in a trans oral, upward directed axial direction and the surface rendered mode. It allows the simultaneous visualization on a single scan of the superior lip, alveolar ridge and secondary palate. It corresponds prenatally to the submental intra oral photography of the palate of neonates. Read More

Authors:

Tracey A. Hotta, RN, BScN, CPSN, CANS, is the owner and president of TH Medical Aesthetics. She is the past president of ASPSN, Editor of the Plastic Surgical Nursing journal, and is a Managing Partner of ACE+ Academia a div of HsuHotta Inc.

Rejuvenation of the perioral region can be very challenging because of the many factors that affect the appearance of this area, such as repeated muscle movement causing radial lip lines, loss of the maxillary and mandibular bony support, and decrease and descent of the adipose tissue causing the formation of "jowls." Environmental issues must also be addressed, such as smoking, sun damage, and poor dental health. When assessing a client for perioral rejuvenation, it is critical that the provider understands the perioral anatomy so that high-risk areas may be identified and precautions are taken to prevent serious adverse events from occurring. Read More

Background: Throughout literature, there are different parameters defining the ideal shape of the lip and lower third of the face. This study was conducted to clarify what it is that makes lips attractive - and whether there are gender-related differences of an attractive lip and lower third of the face.

Patients And Methods: Pictures of the lip and chin region of 176 patients were photographed in a standardised way and evaluated by 250 voluntary judges through an internet presentation by means of an analogue Likert scaling system. Read More

Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.

Background: Although recent research on micro fat has shown the potential advantages of superficial implantation and high stem cell content, clinical applications thus far have been limited.

Objectives: The authors report their experience with superficial enhanced fluid fat injection (SEFFI) for the correction of volume loss and skin aging of the face in general and in the periocular region.

Authors:

Various types of anterior chest flaps can be recruited in the reconstruction of faciocervical region. Most of them were created based on the internal mammary artery and the lateral thoracic artery, and the thoracoacromial artery (TAA) is usually used in pectoralis major musculocutaneous flap. An anterior chest flap with TAA perforator (TAAP) will have no sacrifice of the pectoralis major muscle, but less reports, especially expanded pedicled one, can be reviewed. Read More

Authors:

Background: Acquired angioedema is a rare but recognized manifestation of lymphoproliferative disorders due to deficiency in C1 esterase inhibitor. Normal level of C1 esterase inhibitor proteins in association with angioedema due to lymphoproliferative disease is a rare and an uncommon finding caused by antibodies produced from the underlying disease. Antibodies cause inactivation of C1 esterase inhibitor, thus resulting in C1 esterase inhibitor dysfunction despite of normal quantity of C1 esterase inhibitor. Read More

To adequately perform perioral rejuvenation procedures, it is necessary to understand the morphologic changes caused by facial aging. Anthropometric analyses of standardized frontal view and profile photographs could help to investigate such changes. Photographs of 346 male individuals were evaluated using 12 anthropometric indices. Read More

Authors:

Lips and the perioral area are of outstanding importance in youthful appearance, attractiveness, and beauty. In contrast to younger and middle aged females, there is only scant published data on minimally invasive procedures to restore and revitalize lips and perioral soft tissue in elderly females. In this review we report the signs of aging in this particular region and the underlying anatomy. Read More

Authors:

American Institute for Plastic Surgery and University of Texas Southwestern Medical Center, Dallas, TX, USA.

Background: Disharmonies of the upper lip aesthetic unit generally stem from tall ergotrids and/or thin lips. Comprehension and correction of such defects has been stifled by a lack of metrics and organized systems of diagnosis and treatment.

Methods: The philtral-labial score was devised to better analyze the upper lip region. Read More

Authors:

Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan,

The hidrocystomas (HCs) are cystic forms of sweat gland resulting from proliferation of the apocrine secretory coil or eccrine duct. Apocrine -HCs are cystic lesions that arise from the apocrine secretory coil, while eccrine -HCs represent retention cysts of the eccrine duct. The commonest site for such lesions is around the eye, and they may also occur on the ears, scalp, chest, shoulders, or feet. Read More

Method: Clinical review was conducted from December 2010 to December 2011 among 46 patients complaining of predictable changes on lips and perioral region such as deficiency in contour definition, volume and projection. Lips rejuvenation injections were made using the hyalurostructure technique. Read More

Authors:

Surgical cleft repair aims to restore function of the oro-nasal sphincter and oro-nasal soft tissues and re-establish the complex relationship between perioral and perinasal muscle rings without compromising subsequent mid-facial growth and development. Here we review the surgical anatomy of this region, optimal timing for surgical repair and current thinking on the use of surgical adjuncts. In addition, an overview of current surgical techniques available for the repair of cleft lip, cleft palate and velopharyngeal insufficiency is presented. Read More

Authors:

Closure of perioral surgical defects involving the oral commissures is highly challenging. We describe a 69-year-old male patient with a large basal cell carcinoma of the right perioral region, extending to the right oral commissure. This lesion was radically excised, and the resulting surgical defect was closed using a homolateral double opposing rhomboidal flap. Read More

Authors:

Objectives: The perioral region is subject to a myriad of different treatments for rejuvenation, many of which are applied without a clear understanding of the underlying physiological processes of perioral aging. The results of these procedures are therefore sometimes not optimal and do not achieve a natural youthful appearance. The aim of this study was to put the results of three investigations into the perioral aging process into relation to clinical application in aesthetic medicine. Read More

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Authors:

Departments of Plastic Surgery and Otolaryngology, University Hospitals-Case Western University, Cleveland, Ohio.

There has been minimal attention paid in the literature to the aesthetics of the perioral area, either in youth or in senescence. Aging around the lips traditionally was thought to result from a combination of thinning skin surrounding the area, ptosis, and loss of volume in the lips. The atrophy of senescence was treated by adding volume to the lips and filling the deep nasolabial creases. Read More

Background: The authors report the technical difficulties involved in the procurement of a total human face graft for allotransplantation.

Methods: After completing a preclinical study that involved 13 fresh cadavers, the authors harvested a total face graft for allotransplantation onto a patient in April of 2009. The harvested tissue specimen included the entire face along with the scalp and the auricles. Read More

Authors:

Department of Plastic, Reconstructive and Hand Surgery, University Medical Center, Utrecht, The Netherlands.

Background: Women tend to develop more and deeper wrinkles in the perioral region than men. Although much is known about the complex mechanisms involved in skin aging, previous studies have described histologic differences between men and women with respect to skin aging only incidentally and have not investigated the perioral region.

Objective: The purpose of this study was to investigate gender-specific differences in the perioral skin. Read More

Authors:

Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan.

Between the two different kinds of the skin covering the body, the glabrous skin is found only on the palmo-plantar surface because of its rather simple function to protect the underlying living tissue with its remarkably thick stratum corneum (SC) from strong external force and friction. Thus, its barrier function is extremely poor. In contrast, the hair-bearing skin covers almost all over the body surface regardless of the presence of long hair or vellus hair. Read More

Authors:

Every practitioner has the obligation to offer his or her patients the latest advances in their profession. Dentistry has made a shift over the past 50 years from caries restoration and prosthetic replacement to preventative and esthetic rejuvenation. Related dental specialties have also blossomed with new procedures and an expanded scope of practice. Read More

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Authors:

Department of Orthodontics, Nihon University School of Dentistry, Tokyo, Japan.

Although orthodontic treatment improves dentoalveolar problems, the facial profile seldom changes because the perioral muscles do not easily adapt to the new morphological circumstances. We employed proprioceptive neuromuscular facilitation (PNF), which is training with added resisted movement to motions such as lifting the upper lip, lowering the lower lip, and sticking out the tongue, to adapt the perioral muscles to the new morphological circumstances. The subjects were 40 adults with an average age of 29. Read More

Authors:

The perioral region has certain anatomic characteristics that make it unique and responsive to different types of rejuvenation treatments, including surgery, soft tissue fillers, laser, and chemical peeling. An understanding of the structural anatomy, relationships to other facial units, attractiveness, and analysis of the aging process will help the surgeon select appropriate and long-lasting treatments. This article serves as a basis for facial analysis and preoperative planning, presuming a normal dental-skeletal relationship. Read More

Authors:

Centre for Molecular Biology and Neuroscience and Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

The granule cell layer of the cerebellar hemispheres contains a patchy and noncontinuous map of the body surface, consisting of a complex mosaic of multiple perioral tactile representations. Previous physiological studies have shown that cerebrocerebellar mossy fibre projections, conveyed through the pontine nuclei, are mapped in registration with peripheral tactile projections to the cerebellum. In contrast to the fractured cerebellar map, the primary somatosensory cortex (SI) is somatotopically organized. Read More

Authors:

Department of Communication Sciences and Special Education, Laboratory of Speech-Orofacial Physiology, The University of Georgia, Athens, GA 30602, USA.

Accurate clinical assessment of the infraorbital and mental branch of the trigeminal nerve is aided by an appreciation of the variations in sensitivity that may exist along the surface of the perioral region under examination. The purpose of this investigation was to map the mediolateral spatial and frequency variations in vibrotactile detection capacity to inputs delivered to the upper lip (UL) and lower lip (LL) vermilion. Mechanical vibrotactile inputs at frequencies of 5, 10, 50, and 150 Hz were delivered to three locations on the vermilion of the UL and LL: midsagittally and laterally (left and right) at a point halfway between the midsagittal plane and the oral angle. Read More

Authors:

The dramatic rise in the number of cosmetic procedures performed during the past 5 years reflects a heightened public awareness of and interest in facial rejuvenation. Concomitant with this rise has been the addition of new injectable fillers, lasers, and minimal incision techniques to the surgeon's armamentarium. Perhaps the greatest applicability of these modalities has been the rejuvenation of the perioral region, neck, and jawline, with reduced "downtime" but visible results. Read More

Authors:

The use of flaps to reconstruct lip defects requires detailed knowledge of the local vasculature. New flaps for surgery around the mouth can be devised if the surgeon knows the distribution of the perioral arterial branches. Examination of the anatomy of perioral branches of the facial artery (FA) confirmed the consistent presence of septal and alar branches in the upper lip and a labiomental branch in the lower lip. Read More

Authors:

Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.

Learning Objectives: After studying this article, the participant should be able to: 1. Describe the differing types of congenital clefting defects that extend outward from the perioral region. 2. Read More

Authors:

Division of Neurobiology, Department of Neurobiology and Neuroscience, Weill Medical College of Cornell University, 411 East 69th Street, New York, NY 10021, USA.

We sought to define the contribution of the climbing fibers (CF), one of the major inputs to Purkinje neurons, to the increase in cerebellar blood flow (BFcrb) produced by activation of the cerebellar cortex. The neurotoxin 3-acetylpyridine was used to lesion the inferior olive, the site from which the CF originate. Crus II, an area of the cerebellar cortex that receives sensory afferents from the perioral region, was activated by low-intensity stimulation of the upper lip (5-25 V and 4-16 Hz) in sham-lesioned and lesioned mice. Read More

Authors:

Department of Oral and Maxillofacial Pathology, The Ohio State University College of Dentistry, Columbus 43218-2537, USA.

The histologic finding of a pagetoid epidermotropic growth pattern is associated with a variety of conditions that range from reactive to neoplastic in nature. Included among these conditions is the uncommon skin disorder pagetoid reticulosis. Pagetoid reticulosis may present clinically as a solitary, indolent plaque-like lesion. Read More

Molluscum contagiosum (MC) occurring on the face, lips, and perioral region is a relatively common manifestation of this infectious disease. MC of the intraoral mucosa has been documented, but is rare. This report details the case of a 52-year-old HIV-seropositive man with MC of the gingiva. Read More

Authors:

Division of Otolaryngology and Plastic Surgery, University of New Mexico, Albuquerque, New Mexico 87106, USA.

Reconstruction of the lip and perioral region presents a myriad of problems, as deformities of this region can produce both aesthetic deformation and functional difficulties. This article reviews basic principles of lip reconstruction, emphasizing the differences between defects of the upper and lower lip. Read More

Authors:

Objective: The aim of the study was to visualize different soft tissues in the perioral, nasal, and paranasal region by means of magnetic resonance imaging (MRI) in patients with unilateral cleft lip and palate (UCLP).

Design: In this descriptive study, images of different MRI systems were assessed and compared.

Method: MRI was applied in five consecutive patients operated on for UCLP who underwent secondary lip and nasal correction, two patients who had not had UCLP operations, and five healthy volunteers as controls. Read More

Authors:

We recorded activity from the granule cell layer (GCL) of cerebellar folium Crus IIa as freely moving rats engaged in a variety of natural behaviors, including grooming, eating, and free tactile exploration. Multiunit responses in the 1000-4500 Hz range were found to be strongly correlated with tactile stimulation of lip and whisker (perioral) regions. These responses occurred regardless of whether the stimulus was externally or self-generated and during both active and passive touch. Read More

Crus II is an area of the cerebellar cortex that receives trigeminal afferents from the perioral region. We investigated the mechanisms of functional hyperemia in cerebellum using activation of crus II by somatosensory stimuli as a model. In particular, we sought to determine whether stimulation of the perioral region increases cerebellar blood flow (BFcrb) in crus II and, if so, whether the response depends on activation of 2-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA)-kainate receptors and nitric oxide (NO) production. Read More

Authors:

This pilot study was carried out at the Chang-Gung Memorial Hospital in Taiwan. In order to evaluate this instrument, One-point static (IPDS) cutaneous pressure thresholds were estimated in the perioral region utilizing a hand-held pressure specified sensory device (PSSD). Pressure specified two point discrimination (2PDS) could not be estimated due to the extreme sensitivity of the lip. Read More

Authors:

Two cases of gongylonematiasis in common marmosets of two research facilities in Germany are reported. The helminthiasis was transmitted from colony A to colony B by one infected female and within colony B by cockroaches (Blatella germanica). Four of 40 cockroaches examined in colony B were infected with rhabditiform larvae. Read More

Authors:

Task-dependent human motor organization in the perioral region was examined in eight normal adults who performed oral tasks including lip protrusion, chewing, and speech. Zero phase-lag correlations among EMG signals recorded from quadrants surrounding the lips were calculated in order to determine patterns of motor coupling. Results indicated that the perioral musculature is flexible in output organization. Read More

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Authors:

Department of Plastic Surgery, Yonsei University College of Medicine, Seoul, Korea.

We studied the vascular anatomy of the perioral region by dissecting fresh cadavers. The anatomy of perioral branches of the facial artery consistently confirmed the existence of a septal branch and an alar branch to the upper lip and a vertical labiomental branch to the lower lip. New regional flaps supplied by these perioral arterial branches are proposed in this paper. Read More

Authors:

Institute of Odontology and Stomatology, University of Florence, Italy.

Oral features of Crohn's disease include ulcers, lip fissuring, cobblestone plaques, angular cheilitis, polypoid lesions, and perioral erythema. Pyostomatitis vegetans is a rare eruption of the oral mucosa characterized by tiny yellow pustules. It is considered a marker for inflammatory bowel disease. Read More

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Authors:

From 1985 through 1989, 54 patients with wrinkles around the lips and in the chin area were treated by dermabrasion. Significant improvement, lasting longer than three years, was achieved using both types of abrading tool: the wire brush and the diamond fraise. The side effects of dermabrasion were permanent but very slight bleaching in 66% of the patients and formation of milia in less than 20%. Read More

Authors:

The variable nature of the perioral system as a force generator is due, in large part, to differences in the spatial arrangement and degree of muscle representation in this region. This fact requires careful consideration when attempting to compare select properties of force dynamics among individual subjects in health and disease. The objective of the present study was to determine the relation between an indirect measure of muscle length (interangle span) and in vivo resultant force in the perioral region of normal adult subjects. Read More

Authors:

A study of the involvement of lips and the perioral tissues, by cutaneous leishmaniasis among 492 patients diagnosed to have been affected by the disease at a district general hospital in the Southwest highlands of Saudi Arabia over a period of 18 months is presented together with clinical and diagnostic aspects of such involvement. Differential diagnosis and methods of treatment are briefly discussed. The need for oral and dental surgeons to be acquainted with this not too uncommon condition is stressed. Read More

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